malocclusion

Braces Treatment: Retainers Phase

LAST UPDATED: FEBRUARY 28, 2017

How Long Should Someone Wear a Retainer after Braces are Removed?

It’s the first question a patient asks after their braces come off, we've celebrated the momentous occasion, and handed him a retainer: How long do I have to wear my retainer?

It’s a good and valid question.

I’ll highlight the type of retainer used most often, why retainers are so important and how long you need to wear them.

FAQ

When are retainers used most often?

Orthodontists use the clear plastic retainers most often. Even though there are retainers with a metal wire that go across the front of the teeth, there’s nothing worse than getting your braces off and having an orthodontist put a metal wire in your mouth, saying, “You have to wear this full time for a few months.” So, we use the clear plastic retainer, which fits snuggly around the teeth. It won’t allow the teeth move or turn and, it doesn’t irritate the tongue and lips. When it comes to speaking it usually only takes a day or two to adjust.

 

 

Why are retainers so important?

Retainers are important because when you get your braces off, they moved the teeth into a position they’re not naturally accustomed to. Your teeth were crooked for a reason. Most likely, your mouth and its natural habitat (your tongue, lips and cheeks) caused your teeth to go into the position they were in initially. Now we've put the teeth in almost an unnatural position, a position they didn't want to be in at first. So the teeth and mouth have to adapt to the change. The retainer keeps teeth in place as the tongue, lips and cheeks adjust to their placement. And, the teeth reorganize themselves in the bones and almost “solidify.”

How long should you wear a retainer?

We ask you to wear your retainer full-time for three months, when the teeth tend to move the quickest. You can take the retainer out to eat, to brush your teeth, and for special occasions (i.e., big dates and public speeches). But other than that, you should wear it at least 22-23 hours a day. You’ll notice if you take it out, the teeth will move quickly. After about three months, if everything looks good, we’ll switch you to nighttime wear. Then, you don’t have to worry about taking the retainer in and out at lunch, school, or work. You can just pop it in when you go to bed, take it out in the morning, and your teeth should remain in place.

Do you have to wear a retainer for the rest of your life?

If you want a 100% guarantee that your teeth won’t budge, the only option is to wear the retainer. Some people can eventually stop wearing their retainers. Others will wear retainers more, due to teeth placement and the natural environment of the mouth. After about a year of wearing the retainers at night, I tell patients, “Now it’s your turn to be the orthodontist.” When you take the retainer in and out, you want it to feel passive on your teeth. You don’t want that tight feeling to let you know your teeth moved during the day and you need to wear your retainer more.

If you have that passive feeling when taking the retainer in and out, then you can wear it less and slowly wear it off . You can go from wearing it once a week to a couple of times a month to once a month, but, I caution you to always keep it around and try it on to ensure that passive feeling isn't gone. Unfortunately, if you do see movement, it’s usually too late to fix it with the retainer.

Overall, most people are okay with wearing retainers at night. After all, why not continue wearing the retainers at night, so you know the years spent getting your teeth really nice wasn't a total waste? Let’s face it--there’s nothing worse than having a patient return, (after working so hard to have his teeth look nicer) because his teeth shifted from not wearing the retainer enough.

Feel free to contact Beecroft Orthodontics whenever you want information or help regarding any oral problem you might be experiencing.

Beecroft Orthodontics, 10472 Georgetown Dr. Fredericksburg, Virginia

Phone: 540-898-2200

Braces Treatment: Retainers Phase

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Overbite: Causes & Treatments

overbite

LAST UPDATED: NOVEMER 29, 2017

What are the most common causes of and solutions for overbites?

Having an overbite is a common problem in the North American culture. In other populations, people are more prone to having underbites where their jaws stick out relative to their upper jaws.

In the United States, the majority of people with bite issues have overbites, meaning the top teeth stick out relative to the bottom teeth. Let’s look at the causes, how to treat overbites and the best time for treatment.

Causes of overbites:

1. Genetics: The genes you got from mom, dad, grandma and grandpa are the No. 1 cause. There are two reasons: 1) Your upper jaw is too developed relative to your lower jaw, sticking out too far. This is uncommon. 2) Your lower jaw is underdeveloped, which is most common.

2. A Habit: You may be a thumb-sucker or sucked on a pacifier when you were younger. Habits are easier to fix because we don’t have to remodel and guide the jaws. We just fix the teeth and bring them back into a proper position.

3. Upper teeth stick out further than the lower teeth: That could just be the position the teeth came in. Again, this is easier to fix by bringing the teeth back into a proper position.

How to Treat Overbites?

Several years ago, it was more popular to use headgear to fix large overbite problems, but I don’t like using it. Headgear attaches to the braces in the back of the upper teeth, pulling back the upper jaw. But, the problem is not usually in the upper jaw. Usually the upper jaw is fine. The reason you have an overbite is the lower jaw is set back or detruded. So, if you use headgear to fix an overbite, you cause the upper jaw to match the lower jaw, which is detruded. So, now your teeth fit together, but you have a detruded upper jaw and a detruded lower jaw, which doesn’t look nice aesthetically. This gives you a flat facial appearance, looking like you have fake teeth. So, instead of headgear, we want to correct this problem by encouraging the lower jaw to grow and match that upper jaw.

We can make changes a couple ways:

1. Use elastics: Elastics attach, depending on which way we want the teeth and jaws to move, from the bottom braces to the top ones or vice versa. This lets the upper jaw come out and the lower jaw go in. In cases where there’s an overbite, we would do the opposite because we want the lower jaw to go out and the upper jaw to come in. We use elastics in less severe cases. In severe cases, we have other ways to help guide jaw growth.

2. Use an appliance: If someone has a large overbite, with the lower jaw set back quite far, we use a spring that sits inside the mouth and cheeks. This allows you to chew and open/close your mouth normally. The spring is constantly working to put out a constant amount of force 24 hours a day. The opening and closing motion will put more force on the teeth, allowing the lower jaw to go into a better position. Again, this appliance is used in severe cases where you could stick your whole thumb in between your upper and lower jaw. And, it does speed up treatment quite a bit compared to wearing the elastics.

Photo credit: Send me adrift. via Foter.com / CC BY-NC-ND

Best time for treatment

It’s hard to make the jaw grow more than it would genetically, but timing wise we can remodel the bones to maximize growth potential. The best time is usually before children hit their peak growth spurt--10-11 years old for girls and ages 11-13 for boys. Before they hit the peak growth spurt, their jaws will grow with their lower jaws growing the most.

If you have an overbite, you may want to consider visiting an orthodontist for a consultation. The orthodontists at Beecroft Orthodontics are always happy to help. Visit them today if you have any oral issues.

Beecroft Orthodontics, 10472 Georgetown Dr. Fredericksburg, Virginia

Phone: 540-898-2200

Overbite: Causes & Treatments

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Orthodontic Expanders and Lower Jaw

Can Orthodontic Expanders be used on the Lower Teeth to Avoid Extractions?

Beecroft Orthodontics

An orthodontic expander, also commonly referred to as a "palate-widening device," is commonly used on the top teeth to create space in between the teeth. The device, which is secured around one tooth on each side of the top of the mouth, gradually creates space in the top of the teeth through the course of a few weeks or months. By spacing out the palate, the teeth have more room to shift, which is ideal for patients who plan to get braces. Because the orthodontic expanders create more room at the top of the teeth, it lowers the chances of needing to extract teeth as a method of creating space as well. Since orthodontic expanders are successfully used to create room on the upper teeth, can't the same method be used to resolve crowding with the bottom?

An orthodontist is able to use an expander device on the upper teeth because of the mid-palatal suture in the upper arch of our mouths. The palate can be expanded if there is soft cartilage in the suture. Each time the expander is activated, either at home or by an orthodontist specialist, a gap between the front teeth develops as the teeth space out. But when an expander is used on the lower arch of the teeth, there is no such suture, which doesn't allow them the chance to expand.

The lower arch of the teeth have plates, but they are not similar to that of the upper teeth. They are near the joints, which doesn't allow the palate to widen. The teeth may shift and move, but it will not be a result of a widened palate creating additional space. However, an alternative to the expander device is a a removable retainer device, which has an expansion screw built in, similar to the palate expanders. While there are several alternate ways for the lower arches of teeth, it's important to realize that this will not be shifting bones, but rather just "tipping" teeth. Some orthodontists may even attempt to place springs in the lower arch with wires on the back of the teeth to get them to space out.

If these methods aren't available to you, extraction may be your only option to create space in the lower arch. The dentist typically removes two to four teeth to create the space needed, and the area will be numbed with anesthesia beforehand. The recovery time for extracted teeth is fairly quick, and you will be sent home with gauze and pain relievers to help you get through the following days. The dentist or orthodontist may recommend you only eat soft foods in this time. Your teeth may begin to gradually move on their own once the area has healed.

If you have additional questions about expansion devices, flaring and tipping the teeth, or your options for creating space in the lower arch of your teeth, contact our orthodontist at Beecroft Orthodontics today to schedule a consultation and determine which method of treatment is the right one for you and your smile.

Beecroft Orthodontics, 10472 Georgetown Dr. Fredericksburg, Virginia

Phone: 540-898-2200

Orthodontic Expanders and Lower Jaw

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